The health care coverage and financing landscape for people with and at risk for HIV in the U.S. is highly fragmented and made up of a patchwork of payers and programs. Each has its own eligibility requirements, services and benefits, cost sharing obligations, and financing structure. Further, program eligibility and benefits vary by state and in some cases, even more locally, leading to uneven access across the country and some people are left out of the system entirely. The Affordable Care Act (ACA), passed in 2010, expanded access to coverage and services for millions of people, including people with and at risk of HIV and as a result, the number of uninsured people has fallen significantly. Most people with HIV do have insurance coverage, particularly through Medicaid and private insurance, and many receive support from the Ryan White HIV/AIDS Program, the nation’s safety net program for people with HIV. This table provides an overview of the major payers and programs that provide coverage and services to people with and at risk of HIV. It builds on and updates earlier work published in the Lancet.